Tickly, chesty or downright wracking, most kids suffer from coughs. We ask Dr Kamal Akkach from Health Bay Polyclinic about the causes, cures and treatments

Q: My toddler wakes at night with a loud, barking cough but she’s fine during the day. What’s wrong? does she need antibiotics and how long will it take to get better?

A: This sounds like a classic case of croup – an upper airways viral infection that affects children up to the age of about five. Antibiotics are not necessary. Steam is the best treatment if your child is breathing normally. Giving her a warm bath helps and a humidifier in her room at night is an excellent way to alleviate the symptoms. In four to seven days, it should improve and disappear. However, some bouts of croup can be more serious. If the child has difficulty breathing, a trip to the clinic or hospital is advised. A nebuliser is used to open the airways, and a mild steroid is prescribed to calm the irritation. In both cases, though, the virus will burn itself out within days.

Q: My son developed a cough after a nasty virus a couple of weeks ago. It sounds chesty but he’s running about, eating and doesn’t have a fever. How long will it last and should we medicate?

A: This is fairly typical and, unfortunately, a nasty post-viral cough can hang around for weeks on end. There is nothing to worry about, as long as the cough gradually gets better as time passes. However, parents need to observe their children carefully for any additional symptoms, like a change in the colour of mucus (it should be white – not green), a worsening of the cough, or the onset of a fever. This could be a sign of a bacterial infection setting in. If no other symptoms arise and the cough gradually improves, parents should not be worried. Just be aware that it will take quite some time to go completely.

Q: My daughter coughs when she does any kind of exercise that leaves her breathless. Sometimes she sounds wheezy too. What’s the problem?

A: This sounds very much like exercise-induced asthma. It’s not necessarily full-blown asthma but it is a variant of it, where irritation of the bronchial tubes is set off by physical activity. Usually the treatment is straightforward and effective. We prescribe children Ventolin, which is to be taken prior to exercise. We observe to see if the child is getting better – sometimes the symptoms get better after just a brief spell of treatment. If the asthma persists, we can do exercise tests in the clinic to determine the best course of treatment.

Q: I’m worried my child’s cough is developing into a chest infection. How can I tell if this is the case, and what’s the treatment?

A: If your child develops a cough that seems innocuous but suddenly gets worse and is accompanied by other symptoms, it’s possible that the upper airway infection has spread to the chest. Signs to watch out for are shortness of breath, intensity of the coughing (the child is having problems sleeping because of it) heavy phlegm, green mucus, a fever and lethargy. These are the signs that the cough has become a chest infection and your child needs to see a doctor. Even though the chest infection could be viral, antibiotics are still prescribed in most cases because bacterial infection is the most common cause. Children are susceptible to pneumonia, which can require hospitalisation. This is why a trip to the clinic is advised.

Q: My daughter has a dreadful tickly cough. She’s having frequent bouts that result in her retching. How can I ease the symptoms, and what might be causing it?

A: This sounds like a typical dry cough caused by a viral infection. Viral coughs accompanied by red eyes and a runny nose do get better by themselves after 10 days to two weeks. There is no medication to cure the cough because the virus has to run its course. We would prescribe plenty of fluids, rest and vitamin C as the best course of action. If the cough doesn’t get better and becomes chronic, an allergy is the most likely cause. In this case, antihistamines would be prescribed. If this happens, the child would have to go through a process of elimination to discover the root of the problem. Skin tests can be helpful in discovering certain allergies.Dr Kamal Akkach is a specialist physician in internal medicine and paediatrics the Health Bay Polyclinic, Umm Suqiem (04 348 7140; www.healthbayclinic.com).